First 2 weeks after surgery


  • Protect healing tissue
  • Decrease pain/inflammation
  • Retard Muscle atrophy
  • Avoid strengthening the flexor mass muscle group during this initial phase to allow for healing at medial epicondyle


  • 90 degrees elbow flexion

Weeks 2-4 (1st Post Op Visit is 2 weeks after surgery)

  • Cryotherapy: elbow joint (protect ulnar nerve with towel)
  • Active Assisted ROM
  • Brace: Elbow ROM 0-120 degrees (Gradually increase ROM – 5 degrees, Ext/10 degrees of Flexion per week)
  • Continue wrist ROM exercises
  • Initiate light scar mobilization at incision site


Weeks 3-4


  • Gradual increase to full ROM
  • Promote healing of repaired tissue
  • Regain and improve muscular strength
  • Restore full function of graft/repair site
  • Brace: Elbow ROM 0-140 degrees
  • Continue all exercises listed above
  • Elbow ROM in brace
  • Initiate active ROM Wrist/Elbow (No resistance)
  • Initiate light wrist flexion stretching
  • Initiate active ROM Shoulder:

    • ER/IR tubing
    • Elbow flexion/extension
    • Lateral Raises
  • Initiate light scapular strengthening exercises
  • May incorporate stationary bike for lower extremity
  • D/C brace and use wrist splint
  • Begin light resistance exercises for arm (1lb)
    • Wrist curls, extensions, pronation, supination
    • Elbow extension/flexion
  • Progress shoulder program emphasize rotator cuff and scapular strengthening
  • Initiate shoulder strengthening with light dumbbells


Weeks 6-18


  • Increase strength, power, endurance
  • Maintain full elbow ROM
  • Gradually initiate sporting activities
  • ROM: Elbow ROM 0-135 degrees
  • Continue all Exercises: Progress all shoulder and UE exercises
  • Progress elbow strengthening exercises
  • Initiate shoulder external rotation strengthening
  • Initiate eccentric elbow flexion/extension
  • Continue isotonic program: forearm & wrist
  • Initiate Plank Series: Elbow & Shoulder Stabilization exercises
  • Initiate plyometrics exercise program (2 hand plyos close to body only)
    • Chest pass
    • Side throw close to body
  • Initiate isotonic machines strengthening exercises (if desired)
    • Bench Press,
    • Lat Pulldown
    • Seated Rows
    • Shoulder Presses
  • Initiate sports related positional drills
  • Continue Strength Program
  • Emphasis on elbow and wrist strengthening and flexibility exercises
  • Maintain full elbow ROM
  • Initiate 1 hand plyometric throwing (stationary throws)
  • Initiate 1 hand wall dribble
  • Initiate 1 hand baseball throws into

*Please note: The instructions for rehabilitation protocols are general guidelines to be followed; however, any written or verbal instructions provided by Dr. Allen or his staff should supersede the instructions above and should be followed. If you have questions regarding your rehabilitation protocol, please contact a member of our team.